磁共振弹性成像在宫颈癌诊断中的初步应用研究

A preliminary application study of magnetic resonance elastography in the diagnosis of cervical cancer

目的探究磁共振弹性成像(Magnetic resonance elastography,MRE)在宫颈癌的临床价值。材料与方法本研究前瞻性地招募39名病理诊断为宫颈癌的患者(宫颈癌组),并招募39名年龄、体质指数(body mass index,BMI)相匹配的健康女性志愿者(健康对照组)进行宫颈常规磁共振扫描和频率为60 Hz的MRE检查。测量两组受试者宫颈的弹性值以及宫颈癌组肿瘤的体积及浸润深度,收集宫颈癌组患者的肿瘤分期。选择配对样本t检验比较宫颈癌组和健康对照组的弹性值,采用Spearman秩相关系数及受试者工作特征(receiver operating characteristic,ROC)曲线分析弹性值、肿瘤体积和浸润深度与宫颈癌分期间的相关性及诊断宫颈癌分期的效能。结果宫颈癌患者组的平均弹性值[(5.76±0.99)kPa]显著高于健康对照组[(2.94±0.25)kPa;P<0.001]。弹性值、肿瘤体积及浸润深度在早期(≤ⅡA期)、晚期(≥ⅡB期)宫颈癌之间差异存在统计学意义,且与宫颈癌分期呈正相关(r=0.439、0.384、0.322;P均<0.05)。弹性值的诊断效能优于肿瘤体积和浸润深度,ROC曲线下面积(area under the curve,AUC)分别为0.754、0.722、0.687。结论MRE技术可以作为一种非侵入性的辅助检查手段,帮助宫颈癌的诊断和分期评估,在宫颈癌研究和治疗策略的制订中具有潜在的临床应用前景。

Objective:To explore the clinical value of magnetic resonance elastography(MRE)in cervical cancer.Materials and Methods:In this prospective study,a total of 39 patients diagnosed with cervical cancer(cervical cancer group)were prospectively recruited,along with 39 healthy female volunteers(control group)matched for age and body mass index(BMI).The participants underwent routine cervical MRI and MRE examinations with a frequency of 60 Hz.The stiffness values of the cervix were measured in both groups,along with the volume and depth of infiltration of tumors in the cervical cancer group,were measured.Tumor staging was collected for patients in the cervical cancer group.A paired sample t-test was used to compare the elasticity values between the cervical cancer group and the healthy control group.Spearman's rank correlation coefficient and receiver operating characteristic(ROC)curve analysis were conducted to assess the correlation between stiffness values,tumor volume,infiltration depth,and cervical cancer staging,as well as the diagnostic efficiency of staging cervical cancer.Results:The average stiffness value of the cervical cancer group[(5.76±0.99)]kPa was significantly higher than the healthy control group[(2.94±0.25)kPa;P<0.001].Stiffness values,tumor volume,and infiltration depth showed statistically significant differences between early(≤ⅡA stage)and advanced stage(≥ⅡB stage)cervical cancer and were positively correlated with cervical cancer staging(r=0.439,0.384,0.322;P<0.05).The diagnostic efficacy of stiffness values was superior to tumor volume and infiltration depth,with the area under the curve(AUC)of ROC for stiffness values(0.754)>tumor volume(0.722)>infiltration depth(0.687).Conclusions:MRE technology can serve as a non-invasive adjunct diagnostic tool for the diagnosis and staging of cervical cancer,holding potential clinical application prospects in the research and formulation of treatment strategies for cervical cancer.